Blue Cross Blue Shield of North Dakota (BCBSND) Global Maternity policy
Providers can bill for global maternity care when they handle all aspects of a patient’s pregnancy, including prenatal visits, labor and delivery and postpartum care. This global charge is only appropriate if all these services are delivered by the same physician or qualified healthcare practitioner (QHP), or by another provider at the same location using the same Federal Tax Identification Number (TIN). The global maternity code is submitted after the delivery is completed.
Providers are not required to bill Global Maternity codes. It is imperative to bill either-or, not both.
If the physician does not provide every service covered by the global codes, such as when prenatal care is irregular or starts late, if the pregnancy ends in miscarriage or termination or if the patient switches providers – then delivery, antepartum and postpartum care should be billed separately using specific codes. CPT® maternity care guidelines, along with related articles from CPT Assistant, offer thorough instructions for accurately applying these codes in most situations.
Billing scenario
Maternity care provided by two different physicians practicing at the same location (group).
When two different physicians are practicing at the same location, and both are providing maternity care over the course of the pregnancy (for example, Dr. Blue provides antepartum & postpartum care, and Dr. Cross performs the delivery):
- Global Billing Option: Only a single claim may be filed with the appropriate global maternity CPT code.
- Separate Billing Option: Separate services may be filed based on above policy allowance; however, a global code may not be billed by either provider.
- Dr. Blue would bill for only the antepartum and postpartum care.
- Dr. Cross will bill for only the delivery rendering.
Please visit our BCBSND Global Maternity Policy on our website for more info including but not limited to multiple births, billing scenarios and quality reporting global maternity.
Questions?
Contact the Provider Service Center by calling the number on the back of the member ID card.
- Commercial: 800-368-2312
- Medicaid Expansion: 833-777-5779
